The new entity, Phoenix, did not yet have enough doctors lined up to staff the ER.
The new doctors will be unfamiliar with the ER layout, the computer system, the nurses, the ambulance drivers, and the workflow in general. In addition, no one has talked to the current group of ER doctors yet about how the transition will happen.
“There has been no communication from the hospital about how to manage midnight on Dec. 28,” Dr. Mark Jaben said. “If I have a patient at 11:59 p.m., what do I do at 12:01 a.m. when I’ve been terminated?”
Phoenix maintains it has an excellent transition plan, but would not share the plan with the current ER doctors, Jaben said.
“They said it was proprietary,” Jaben said.
Audience members asked who Phoenix will find to staff the ER with the changeover barrelling down.
“The doctors they will manage to bring in the first days or weeks will probably be flown in to do a shift or two at an exorbitant rate that Phoenix is willing to pay to get through these first few weeks,” Dr. Ely Zaslow said. “There is a very consistent pattern to how these groups work.”
Doctors urged the public to keep supporting the hospital in light of the controversy and not to boycott the hospital ER as has been suggested by some members of the public in letters to the editor.
“Don’t abandon the hospital,” Dr. Tom Sither of Haywood Emergency Physicians told an audience of 75 people. “None of us want the hospital to be abandoned even though we disagree. We have been cheerleaders for the hospital for many years, and we don’t want the hospital to suffer.”
Members of the audience and the medical community suggested that hospital CEO David Rice manipulated the hospital board to get rid of the ER doctors due to a personality conflict between Rice and a couple of the ER doctors. They suggested Rice controlled the flow of information to the hospital board, sequestering them from information he didn’t want them to have.
The ER doctors agreed.
“How has the board made its decisions? With what information and from who?” Jaben said. “One of the big issues in all of this is who is hearing what, from whom and when.”
When the doctors were asked if, in hindsight, there is anything they would do differently, Sither said he should have done more while serving as the hospital chief of staff in 2005 to open lines of communication between the hospital board and medical community.
“I wish as chief of staff in 2005 I had taken the initiative to have more communication between the board and medical staff so this wall that has been built up for various reasons could be taken down,” Sither said. Sither said the board needs to hear a variety of opinions from the entire medical community, not just hospital administration, in order to make informed decisions.
A couple of times in the forum, audience members spoke poorly of Rice, even calling for his resignation. The ER doctors attempted to diffuse those comments, however.
“We are not advocating for Mr. Rice to lose his job,” Jaben said. Jaben said they just want to keep theirs.
“We have been here a long time and would like to stay and continue to take care of people in this community,” Jaben said.
One audience member said the ER doctors should sue the hospital for a breach of contract.
“Litigation is only thing that would bring this to a head,” said Roscoe Wells.
The ER doctors said they do not want to do that, however.
“We are still hopeful this could be turned around,” Zaslow said.
The public forum was held two days before a hospital board meeting, considered the last chance to change the hospital board’s mind.
“The board is being told now to ‘Dig in. It is going to blow over. Don’t back down,’” Zaslow said.
Zaslow was right. Despite an appeal to the hospital board by the medical community, the hospital board stuck by its decision to oust the ER doctors. (See related article.)
Haywood Emergency Physicians have not decided what they will do next. Some might simply want to move on and start new lives elsewhere, others might fight to get their jobs back.
“Just because we are not there on the 28th, just because we are gone doesn’t mean we can’t come back,” Zaslow said. “It is not going to be over.”
Another audience member said it is up to the public to keep the pressure on the hospital.
“If we set here and let this happen, we have nobody to blame but us,” said Harley Caldwell, an audience member.
Jaben commended the audience for taking part in decisions that ultimately will affect their health care.
“The emergency department is the health care safety net in this community as it is in communities across the country,” Jaben said. “I think this community should be commended for taking ownership in this issue. This struggle at its core is about how the hospital makes decisions that impact health care in the community.”
The ER doctors said the hospital administration never articulated clearly what its grievances were, prompting them to terminate their contract when there was still 18 months left on it.
“They would not clarify these issues with us,” Sither said.
Zaslow said it seemed Rice’s aim was to get rid of Haywood Emergency Physicians at all cost.
“His agenda is to get rid of us and has been to get rid of us,” Zaslow said. “It’s not about the shifting list of things you hear.”
In the wake of public outcry, hospital administration has attempted to justify the decision with various “sticking points” they allegedly have with Haywood Emergency Physicians, said Zaslow. These points were not mentioned in the context of contract talks, which would have given the doctors a chance to address them, Zaslow said.
“The major sticking point has been a very elusive phenomenon. There have been five or six so-called major sticking points. None have the hospital been able to latch on to or defend for any length of time,” Zaslow said.